早期に修復した外傷性硬脳膜下血腫の1剖検例

AN AUTOPSY CASE OF RAPIDLY ORGANIZED TRAUMATIC SUBDURAL HEMATOMA

まえがき

　Virchow （1856）が慢性出血性硬脳膜炎と記載したものは，慢性に経過した硬脳膜下血腫であり，その大半が外傷に起因するものである，というのが最近の通説である。

　硬脳膜下血腫の修復機転は胸腹腔の漿膜面における血腫と異り，もつばら硬脳膜側より始まり，完成し，蜘蛛膜は全くこれに関与しないことが特異であるとされている。

A 79 years old male who was injured by a traffic accident was hospitalized under diag-nosis of traumatic intracranial hemorrhage. He expired after 10 days with main comlaints of unconsciousness and high fever. An aut-opsy was performed and found a perfectly encapsulated subdural hematoma by thick fibrous connective tissue at the right hemis-phere, and right-sided massive bleeding of thebrain stem. In addition to the foregoing les-ions, a large lineal fracture from the left me-sial cranial cavity to right temporal bone was noted. Although the pulmonary tissue dispayed bilateral hypostatic pneumonia, it was convinced that the direct cause of death should be regarded as the post-traumatic apo-plexy.

The family stated that he had been heal-thy until he had accepted the injury, furthe-rmore, on the pathological standpoint, there was no discrepancy between microscopical fin-dings of the cerebral changes and post-trau-matic survival duration.

This is exceedingly rare case and worthy of mentioning on the fact that subdural he-matoma was encapsulated perfectly by a thick fibrous connective tissue in such a short period.